저음역 돌발성 난청 환자에서 고실 내 덱사메타존 주입술 및 경구 스테로이드 병합 요법의 효과와 경구 스테로이드 복용량 조절을 위한 예비연구
Preliminary Study for Control of Dosage of Oral Steroid and Effect of Intratympanic Dexamethasone Injection with or Without Oral Steroid as Treatment in Sudden Low Tone Hearing Loss
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Prevalence of low tone sudden sensorineural hearing loss (LSSNHL) has increased. However there was no definite treatment regimen of LSSLHL. The objective of this study is to analyze results of oral steroid therapy and intratympanic steroid injection (ITSI) as first line therapy for LSSLHL. Addtionally, we compared side effects as treatment modality. Materials and Methods:We studied retrospectively 43 patients with LSSLHL at Jeju National University Hospital from March 2010 to July 2011. Under approval of patients we classified patients into 3 groups as treatment types. Patients to be treated with only ITSI were classified as group I (n=11), patients to be treated with ITSI and high dose oral methylprednisolone (1 mg/kg/day) were classified as group II (n=9) and patients to be treated with ITSI and half dose oral methylprednisolone (0.5 mg/kg/day) were classified as group III (n=23). Patients got 3 times of ITSI for a week. Before injection we warm-ed up dexamethasone (5 mg/mL) ample and we injected at posterosuperior portion of tympanic membrane. We carried out a pure tone audiometry (PTA) on the 1st day of their visit to hospital and before injection. We compared change of bone conduction threshold at 250, 500 and 1,000 Hz between 3 groups. Results:The hearing threshold of patients improved regardless of groups since the treatment. And there was no clinically significant differences in the outcome between groups. Conclusions:We could use ITSI as therapy in LSSLHL. If we used oral steroids for treatment of LSSLHL, we could consider reduction dosage of them.
Abstract
Prevalence of low tone sudden sensorineural hearing loss (LSSNHL) has increased. However there was no definite treatment regimen of LSSLHL. The objective of this study is to analyze results of oral steroid therapy and intratympanic steroid injection (ITSI) as first line therapy for LSSLHL. Addtionally, we compared side effects as treatment modality. Materials and Methods:We studied retrospectively 43 patients with LSSLHL at Jeju National University Hospital from March 2010 to July 2011. Under approval of patients we classified patients into 3 groups as treatment types. Patients to be treated with only ITSI were classified as group I (n=11), patients to be treated with ITSI and high dose oral methylprednisolone (1 mg/kg/day) were classified as group II (n=9) and patients to be treated with ITSI and half dose oral methylprednisolone (0.5 mg/kg/day) were classified as group III (n=23). Patients got 3 times of ITSI for a week. Before injection we warm-ed up dexamethasone (5 mg/mL) ample and we injected at posterosuperior portion of tympanic membrane. We carried out a pure tone audiometry (PTA) on the 1st day of their visit to hospital and before injection. We compared change of bone conduction threshold at 250, 500 and 1,000 Hz between 3 groups. Results:The hearing threshold of patients improved regardless of groups since the treatment. And there was no clinically significant differences in the outcome between groups. Conclusions:We could use ITSI as therapy in LSSLHL. If we used oral steroids for treatment of LSSLHL, we could consider reduction dosage of them.
참고문헌 (11)
- Morita S, "A comparison of the shortterm outcome in patients with acute low-tone sensorineural hearing loss", ORL J Otorhinolaryngol Relat Spec, 72(6), pp.295~299 (2010)
- Abe T, "Acute sensorineural hearing loss in low tone frequencies", Otolaryngology, 54, pp.385~392 (1982)
- Imamura S, "Clinical observations on acute low-tone sensorineural hearing loss. Survey and analysis of 137 patients", Ann Otol Rhinol Laryngol, 106(9), pp.746~750 (1997)
- Chandrasekhar SS, "Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation", Otol Neurotol, 22(1), pp.18~23 (2001)
- Alatas N, "Use of intratympanic dexamethasone for the therapy of low frequency hearing loss", Eur Arch Otorhinolaryngol, 266(8), pp.1205~1212 (2009)
- Yamasoba T, "Acute low-tone sensorineural hearing loss without vertigo", Arch Otolaryngol Head Neck Surg, 120(5), pp.532~535 (1994)
- Parnes LS, "Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application", Laryngoscope, 109(7), pp.1~17 (1999)
- 강우석, "돌발성 난청의 치료 원칙", 대한이비인후과학회지 두경부외과학, 54(10), pp.675~682 (2011), 대한이비인후과학회
- Fuse T, "Short-term outcome and prognosis of acute low-tone sensorineural hearing loss by administration of steroid", ORL J Otorhinolaryngol Relat Spec, 64(1), pp.6~10 (2002)
- Fushiki H, "Prognosis of sudden low-tone loss other than acute low-tone sensorineural hearing loss", Acta Oto-Laryngologica, 130(5), pp.559~564 (2010)
- Spear SA, "Intratympanic steroids for sudden sensorineural hearing loss: a systematic review", Otolaryngol Head Neck Surg, 145(4), pp.534~543 (2011)
